The undersigned members
of the Cancer Leadership Council write to express their concerns regarding
potential changes in payments for cancer therapies reflected in the proposed
rule for the Hospital Outpatient Prospective Payment System (OPPS) for
calendar year 2007. Modifications to payments for cancer drugs and radioimmunotherapies
as proposed by the Centers for Medicare & Medicaid Services (CMS)
could have a negative impact on patient access to potentially life-saving
therapies.

If, as proposed, payment
for cancer drugs is reduced from 106% of average sales price (ASP) to
105% of ASP, hospitals with a heavy concentration of cancer patients may
suffer losses that could eventually exert a negative impact on individual
patient access to these drugs. We understand that surveys of community
cancer centers indicate that a number of cancer drugs would not be available
for prices equal to or less than the proposed Medicare payment rate. Under
such circumstances, cancer providers in the hospital outpatient setting
will have a disincentive to utilize these drugs and, if the trend persists,
these institutions will be disinclined to maintain the services provided
to cancer patients. We urge CMS to reconsider the proposed reduction of
payment for calendar year 2007 to ensure that patient access to cancer
care in the outpatient setting is not compromised.

CMS proposes to set a fixed rate for radiopharmaceuticals in 2007. Although
this modification in payment methodology may be advisable, we are concerned
that the data that will be utilized to set the payment rate may not be
complete and up-to-date. It is projected that the rate of payment may
be cut in half from 2006 to 2007, a reduction that could have a significant
impact on availability of radioimmunotherapies for treatment of non-Hodgkin's
lymphoma. We recommend that this change be delayed until there are assurances
that the data supporting the new payment rate are accurate and complete,
and that particular attention be given to high-cost radiopharmaceuticals,
for which a special payment methodology may be necessary.

We urge CMS to carefully
consider these issues that may affect patient access to cancer care in
the outpatient setting.